Heart Health

Heart disease is the leading killer of Canadians. There are some risk factors
you can't change, such as family history, age, and race. However, there are
many important risk factors that you can work on: high blood pressure, high
cholesterol, smoking, and a sedentary lifestyle. Whatever your age, you can
work towards a healthier heart.

Heart attack: Know the symptoms

The key to surviving a heart attack is getting medical help early – nearly
half of all deaths due to heart attack occur within three to four hours of the
beginning of symptoms.

Keep in mind that not everyone experiences the same heart attack symptoms to
the same degree – some older people and women can experience less obvious symptoms.
Some heart attacks come on suddenly, but the vast majority start slowly with
mild pain and discomfort. Many people experiencing a heart attack are not sure
they are having one and may think it's only heartburn or indigestion. This may
result in not seeking medical attention promptly.

Therefore, it's critical to be familiar with and recognize heart attack symptoms,
and to take them seriously. The following are heart attack warning symptoms:

pain or discomfort in the chest, shoulder, arm, back, neck, or jaw that
does not go away with rest (in women, pain may be more vague)

pressure, heaviness, fullness, or squeezing in the chest

shortness of breath

nausea and/or vomiting

sweating, or cool and clammy skin

anxiety

light-headedness or sudden dizziness

If you experience these warning symptoms, the Heart and Stroke Foundation suggests
doing the following things:

Call 9-1-1.

Stop all activity and rest (sit or lie down).

If you are taking nitroglycerin, take your usual dose.

If the 9-1-1 operator advises it, and you are not allergic to ASA, chew and swallow one 325 mg ASA tablet or two 81 mg tablets.

Putting the cuffs on hypertension

Have you been tested for high blood pressure? Your doctor may put a cuff on your arm as part of a routine check-up to test your blood pressure. High blood pressure (hypertension) is caused by blood pushing too hard against the walls of your blood vessels, and it can be a serious medical condition. If your blood pressure levels are above normal, you might be at increased risk for heart disease and stroke.

Your doctor can test your blood pressure levels at a clinic or hospital, but you can also test your blood pressure yourself. Measuring your blood pressure at home is helpful for two reasons. First, some people get higher-than-usual blood pressure readings at the doctor's office, usually because they are a bit nervous. Second, people with hypertension need to monitor their blood pressure regularly. Blood pressure normally changes daily, rising during activity and falling during sleep. The best way to get good readings is to check yourself at the same time of day.

You should also take occasional readings at different times during the day and evening. This can help you determine the effects and effectiveness of blood pressure medications. Ask your doctor how often you should monitor your blood pressure.

If you test your blood pressure at home, you have three types of home monitors to choose from:

The manual inflation device. Wrap the cuff around your arm and use a pump to inflate it.

The automatic inflation device. Push a button to inflate the cuff. It then deflates at the rate needed for an accurate test.

The wrist cuff. Wrap the cuff around your wrist and push a button to inflate the cuff. These types of monitors are not usually recommended because it's more difficult to get an accurate reading.

Talk to your doctor or pharmacist about whether home monitoring is a good idea for you and which type of monitor would best suit your needs.

Most home monitors give extremely accurate readings. The monitor will show systolic and diastolic blood pressure, for instance 120/80. Systolic, the higher number (e.g., 120 in 120/80), refers to the measurement taken when your blood surges from your heart pushing it out (the main "thump" part of the heartbeat). Diastolic, the lower number (e.g., 80 in 120/80), refers to when your blood is being pulled back towards the heart by the heart expanding (the off-beat of the heartbeat).

Most home monitors also show a reading on your heart rate or pulse (how many times a minute your heart is beating). Normal rates vary between 60 and 100 beats per minute. Many monitors have a tiny computer in them that lets you compare a reading with previous ones. Make sure you get a cuff size that fits well. If it's too small or big, it may give false readings.

For most people, the blood pressure target is usually less than 140/90 taken at the doctor's office or less than 135/85 taken at home. For people with diabetes, the target is less than 130/80. Depending on your medical conditions, your doctor may recommend different blood pressure targets. Talk to your doctor to find out what your targets should be.

Stop smoking. Breathe easy.

It takes practice and time to quit smoking, but it can be done, and the benefits of stopping smoking are worth the effort. There are many ways to quit smoking, such as the "cold turkey" method or a system to gradually taper off smoking. Each person is unique, and different strategies work better for different people.

Smoking cessation medications

Smoking cessation medications include nicotine chewing pieces (gum), the nicotine patch, nicotine inhaler,oral sprays, nicotine lozenges, bupropion, and varenicline. Research shows that when used as directed and combined with support groups or counselling, these medications can increase your chance of success. Speak to your doctor or pharmacist about which medications may be appropriate for you.

Support groups and counselling

Group programs usually involve meeting small groups of people who are all trying to quit smoking. Group support programs have proven one of the most successful methods for quitting smoking. Qualified health professionals lead some group programs, and these tend to be more effective. Contact your local public health department to locate any smoking cessation groups active in your community.

Individual counselling programs range from brief advice and counselling offered by a health care professional to intensive counselling available through specialty clinics. These clinics are not available everywhere, but are especially helpful for certain smokers. Talk to your doctor about whether individual counselling is an appropriate option for you.

Tips for quitting

The process of quitting smoking may be hard, but it can be done!

Here are some tips to help you quit:

Develop an action plan to improve your chances of quitting. Writing the plan down will help you think more carefully about what you need to do and how you will approach it. Try the following:

Pick a day as your "quit date," which is the day you intend to stop smoking. Write this date down.

Make a list of the important benefits of quitting and read it over before and after you quit. Use this list while you are trying to quit to remind yourself of your reasons for quitting.

List the situations in which you smoke and the reasons why you smoke – this will help you identify what "triggers" you to light up.

List fun and healthy activities to replace smoking, and be ready to do these when you feel the urge to smoke.

Avoid smoking triggers. Starting with your quit date, try to remove or avoid your smoking triggers. For example, if you associate coffee with smoking, try drinking tea or water instead. If you usually smoke at parties, find other ways to socialize with friends until you feel comfortable and confident about facing these situations.

Don't carry matches, a lighter, or cigarettes.

Each day, delay lighting your first cigarette by one hour. After the first cigarette, when you have your next craving to smoke, delay for another 15 minutes or half an hour. By delaying each cigarette, you take control.

Familiarize yourself with possible withdrawal symptoms and how you plan to handle them.

Get moving! Exercise is a great way to relax and feel good; use exercise rather than smoking to deal with stress. As you exercise, with each deep breath you take, you can start to repair some of the damage done to your body from smoking.

Build your own support network. Enlist the help of a close friend or family member, your doctor, someone you know and respect who has recently quit, or someone who wants to quit smoking with you.

The skinny on cholesterol

Cholesterol is a fat-based substance found in the bloodstream and the body's cells. Cholesterol is essential for good health: it builds and repairs cells, protects nerve fibres, and is used to produce certain hormones and bile acids. We get it in two ways: the liver produces it, and it is contained in some of the foods we eat, including meat, chicken, fish, eggs, and dairy products. A healthy daily intake of cholesterol is about the amount found in a single egg. Most of us take in more than that, which is where problems can begin.

When cholesterol moves through our blood, it joins up with proteins to make molecules known as lipoproteins. "Bad" cholesterol, or low-density lipoproteins (LDL), can build up on the walls of blood vessels, where it can block and damage arteries. This can eventually cause heart disease and stroke. But there's also "good" cholesterol, high-density lipoproteins (HDL), which clear away the dangerous, “bad” type of cholesterol.

Although LDL is the one to worry about, getting accurate readings of both kinds is essential. High levels of "bad" cholesterol and low levels of "good" cholesterol mean you could be at risk of heart disease.

Triglycerides are not a type of cholesterol but are another type of fat found in the body. Like LDL, high triglycerides are associated with heart disease. Triglyceride levels are often measured at the same time as cholesterol levels.

Many factors determine whether your LDL-cholesterol is high or low, including:

diet

weight

level of physical activity

age (cholesterol levels rise with age)

sex (men have higher cholesterol)

alcohol consumption

heredity

some medical conditions, such as diabetes, hypothyroidism, liver disease, and kidney disease

To help lower cholesterol levels:

Enjoy a diet high in whole-grain foods, vegetables, fruits, and legumes.

Drink alcohol in moderation (for men, no more than 3 drinks per day on most days, up to a maximum of 15 drinks per week; for women, no more than 2 drinks per day on most days, up to a maximum of 10 drinks per week).

Take cholesterol medications (if necessary) as prescribed by your doctor.

Regardless of what your cholesterol level is, the above lowering cholesterol suggestions are recommended for everyone for good heart health!

Should you have your cholesterol levels tested?
It is recommended that you have your doctor check your cholesterol levels and assess your risk of heart disease every 5 years once you are over the age of 40. Some conditions require testing of cholesterol levels regardless of age; these include but are not limited to:

diabetes

family history of heart disease

hypertension

currently smoking

obesity

chronic kidney disease

inflammatory bowel disease

chronic obstructive pulmonary disease

Your doctor may have provided your cholesterol readings as a ratio of total cholesterol to HDL. Contact your doctor or pharmacist if you have questions about managing your cholesterol.